1659445500 NPI number — DRS HARPER & GILMORE INC

Table of content: (NPI 1659445500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659445500 NPI number — DRS HARPER & GILMORE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS HARPER & GILMORE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DENTAL OFFICE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659445500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2250 WARRENSVILLE CENTER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-932-0433
Provider Business Mailing Address Fax Number:
216-932-1245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2250 WARRENSVILLE CENTER ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIVERSITY HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-932-0433
Provider Business Practice Location Address Fax Number:
216-932-1245
Provider Enumeration Date:
11/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WARE
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
BOBBICA
Authorized Official Title or Position:
FINANCIAL MANAGER
Authorized Official Telephone Number:
216-932-0433

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  17091 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 18761 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)